{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:43:16Z","timestamp":1782175396651,"version":"3.54.5"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,8,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>To assess the effectiveness of in-person and webinar-delivered AFIX (Assessment, Feedback, Incentives, and eXchange) consultations for increasing adolescent vaccine coverage.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We randomly assigned 91 primary care clinics in North Carolina, serving 107\u2009443 adolescents, to receive no consultation or an in-person or webinar AFIX consultation. We delivered in-person consultations in April through May 2011 and webinar consultations in May through August 2011. The state's immunization registry provided vaccine coverage data for younger patients (ages 11\u201312 years) and older patients (ages 13\u201318 years) for 3 adolescent vaccines: tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap); meningococcal; and human papillomavirus (HPV) vaccines (\u22651 dose, females only).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>At the 5-month follow-up, AFIX consultations increased vaccine coverage among younger adolescents. Patients in the in-person arm experienced coverage changes that exceeded those in the control arm for Tdap (3.4% [95% confidence interval (CI): 2.2 to 4.6]), meningococcal (4.7% [95% CI: 2.3 to 7.2], and HPV (1.5% [95% CI: 0.3 to 2.7]) vaccines. Patients in the webinar versus control arm also experienced larger changes for these vaccines. AFIX did little to improve coverage among older adolescents. At 1 year, the 3 arms showed similar coverage changes. The effectiveness of in-person and webinar consultations was not statistically different at either time point (all, P &amp;gt;.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Webinar AFIX consultations were as effective as in-person consultations in achieving short-term increases in vaccine coverage for younger adolescents. AFIX consultations for adolescents need improvement to have a stronger and more durable impact, especially for HPV vaccine.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2013-4257","type":"journal-article","created":{"date-parts":[[2014,7,8]],"date-time":"2014-07-08T03:14:22Z","timestamp":1404789262000},"page":"e346-e353","source":"Crossref","is-referenced-by-count":78,"title":["Increasing Provision of Adolescent Vaccines in Primary Care: A Randomized Controlled Trial"],"prefix":"10.1542","volume":"134","author":[{"given":"Melissa B.","family":"Gilkey","sequence":"first","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, and"},{"name":"Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda M.","family":"Dayton","sequence":"additional","affiliation":[{"name":"North Carolina Division of Public Health, Raleigh, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Moss","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia C.","family":"Sparks","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy H.","family":"Grimshaw","sequence":"additional","affiliation":[{"name":"North Carolina Division of Public Health, Raleigh, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Bowling","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel T.","family":"Brewer","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, and"},{"name":"Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2014,8,1]]},"reference":[{"issue":"34","key":"2021120906520987500_B1","first-page":"685","article-title":"National and state vaccination coverage among adolescents aged 13-17 years\u2014United States, 2012.","volume":"62","author":"Centers for Disease Control and Prevention (CDC)","year":"2013","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021120906520987500_B2","unstructured":"Centers for Disease Control and Prevention. AFIX (Assessment, Feedback, Incentives, and eXchange). Available at: www.cdc.gov\/vaccines\/programs\/afix\/index.html. Accessed October 1, 2013"},{"issue":"8","key":"2021120906520987500_B3","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1001\/archpedi.153.8.879","article-title":"Changes in clinic vaccination coverage after institution of measurement and feedback in 4 states and 2 cities.","volume":"153","author":"LeBaron","year":"1999","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"2","key":"2021120906520987500_B4","doi-asserted-by":"crossref","first-page":"171","DOI":"10.2105\/AJPH.89.2.171","article-title":"The impact of physician bonuses, enhanced fees, and feedback on childhood immunization coverage rates.","volume":"89","author":"Fairbrother","year":"1999","journal-title":"Am J Public Health"},{"key":"2021120906520987500_B5","unstructured":"Community Preventive Services Task Force. Universally recommended vaccinations: provider assessment and feedback. Available at: www.thecommunityguide.org\/vaccines\/universally\/ providerassessment.html. Accessed March 3, 2014"},{"key":"2021120906520987500_B6","unstructured":"Centers for Disease Control and Prevention. Immunization information systems: 2011 IISAR data participation rates. Available at: www.cdc.gov\/vaccines\/programs\/iis\/annual-report-IISAR\/2011-data.html#adolescent. Accessed March 3, 2014"},{"issue":"12","key":"2021120906520987500_B7","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1001\/jama.290.12.1624","article-title":"Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy.","volume":"290","author":"Tunis","year":"2003","journal-title":"JAMA"},{"issue":"1","key":"2021120906520987500_B8","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1748-5908-9-21","article-title":"Comparing in-person and webinar delivery of an immunization quality improvement program: a process evaluation of the adolescent AFIX trial.","volume":"9","author":"Gilkey","year":"2014","journal-title":"Implement Sci"},{"key":"2021120906520987500_B9","unstructured":"Centers for Disease Control and Prevention. CoCASA (Comprehensive Clinic Assessment Software Application). Available at: www.cdc.gov\/vaccines\/programs\/cocasa\/index.html. Accessed March 3, 2014"},{"key":"2021120906520987500_B10","unstructured":"Centers for Disease Control and Prevention. Vaccines for Children Program. Available at: www.cdc.gov\/vaccines\/programs\/vfc\/index.html. Accessed March 3, 2014"},{"key":"2021120906520987500_B11","unstructured":"US Census Bureau. Metropolitan and micropolitan statistical areas. Available at: www.census.gov\/population\/metro\/. Accessed March 3, 2014"},{"issue":"34","key":"2021120906520987500_B12","first-page":"671","article-title":"National and state vaccination coverage among adolescents aged 13-17 years\u2014United States, 2011.","volume":"61","author":"Centers for Disease Control and Prevention (CDC)","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021120906520987500_B13","unstructured":"Centers for Disease Control and Prevention. City\/state\/territory AFIX staff. Available at: www.cdc.gov\/vaccines\/programs\/afix\/contacts\/city-state.html. Accessed March 3, 2014"},{"issue":"6","key":"2021120906520987500_B14","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.2105\/AJPH.2012.301035","article-title":"Population-based versus practice-based recall for childhood immunizations: a randomized controlled comparative effectiveness trial.","volume":"103","author":"Kempe","year":"2013","journal-title":"Am J Public Health"},{"issue":"14","key":"2021120906520987500_B15","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1001\/jama.284.14.1820","article-title":"Effect of patient reminder\/recall interventions on immunization rates: a review.","volume":"284","author":"Szilagyi","year":"2000","journal-title":"JAMA"},{"issue":"3","key":"2021120906520987500_B16","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.acap.2013.01.002","article-title":"A randomized trial of the effect of centralized reminder\/recall on immunizations and preventive care visits for adolescents.","volume":"13","author":"Szilagyi","year":"2013","journal-title":"Acad Pediatr"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/134\/2\/e346\/1103891\/peds_2013-4257.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/134\/2\/e346\/1103891\/peds_2013-4257.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T01:11:05Z","timestamp":1639098665000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/134\/2\/e346\/32982\/Increasing-Provision-of-Adolescent-Vaccines-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,8,1]]},"references-count":16,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2014,8,1]]},"published-print":{"date-parts":[[2014,8,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2013-4257","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,8,1]]}}}